Wiki coding papular lesion of tongue scissor excision & biopsy

ccr888

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Hello! I'm a new coder in my first year working for a family physician who regularly performs lesion removals. This is the first time I've coded a lesion on the tongue, which falls into the Digestive not the Integumentary section of the CPT.

Documentation shows a scissor removal of 3mm papular lesion of the tongue (anterior 2/3) and base electrodessication accomplishing full-thickness removal. Pathology reports it as an Irritation Fibroma (which I'm ICD-10 coding as D10.1).
My search through the CPT Index leads me to:

41100 Biopsy of tongue; anterior two-thirds.
41110 Excision of lesion of tongue without closure.

Can any one tell me if I'm on the right track with these codes? After talking with the doctor, we decided to use 41110 only.

Many thanks!
Cheryl
 
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Further thoughts...

My confusion/hesitancy is about coding the tongue procedure (Digestive System) from the Integumentary section.

Is the answer obvious to everyone else? Can anyone please point out what I'm missing?

Thanks for any input!
 
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The 41XXX codes are correct - biopsy if only a piece of it - 41100, and excision if he removed the entire lesion - 41110. If the electrodessication of the base is only for hemostasis, those codes are OK. However, it would be technically Unlisted 41999 relate to 41110 if he destroyed the lesion w/electrodessication. You definitely would not use an Integ. code since those are for skin/subcu.
 
I am billing 41110 but this is the first time the doctor removed 2 lesions.
How would you bill that with Medicare?

41110
41110-XS ?

Can anyone assist?
 
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